Gait initiation in older adults with postural instability
Gait initiation in older adults with postural instability
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DOI：
10.1016/j.clinbiomech.2008.02.012
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发表时间：
2008-07-01
影响因子：
1.8
通讯作者：
Gregor, Robert J.
中科院分区：
文献类型：
--
作者：
Hass, Chris J.;Waddell, Dwight E.;Gregor, Robert J.
背景：本研究检测了两组姿势不稳定的老年人在前向步态和侧向步态(90度)启动过程中压力中心的变化。在启动试验中，对28名过渡到虚弱状态的老年人和16名帕金森氏症患者进行了评估。计算了压痕中心的位移、速度和光滑度，并对结果进行了比较。两组都产生了压力中心的移动，与健康人群相比，压力中心的移动平均减少了。转化为虚弱的成年人能够调整运动程序的输出，因此推动身体朝着预定运动方向的力量最大化，压力中心的运动就是明证。转化为虚弱的成年人产生了更类似于健康成年人的压力中心轨迹模式，而帕金森氏症患者产生的轨迹对产生有效的正向和侧向步态启动都是适得其反的。这些发现表明，帕金森氏症患者即使在服药状态下，在向前和侧向步态开始时也表现出低效的姿势调整，而且这些姿势调整更容易因与帕金森氏症相关的中枢和外周变化的复杂相互作用而恶化，而不是单纯的衰老。(C)2008爱思唯尔有限公司。保留所有权利。
Background This study examined changes in the translation of the center of pressure during forward and lateral (90 degrees to the side) gait initiation in two populations of older adults with postural instability.Methods. Twenty-eight older adults transitioning to frailty and 16 persons with Parkinson's disease in the "on medication state" were evaluated during initiation trials. Displacements, velocities, and smoothness of the center of pressure trace were calculated and compared.Findings. Both groups produced movements of the center of pressure that on average were reduced compared to healthy populations. Adults transitioning to frailty were able to scale the output of the motor program so forces that propel the body in the intended direction of movement were maximized as evidenced by movements of the center of pressure. The adults transitioning to frailty produced patterns of center of pressure trajectories that were more similar to healthy adults where as individuals with Parkinson's disease produced trajectories that were counterproductive to producing efficient gait initiation in both the forward and lateral direction.Interpretation. These findings suggest that persons with Parkinson's disease even when in the medicated state exhibit inefficient postural adjustments during both forward and lateral gait initiation and that these postural adjustments are more susceptible to deterioration from the complex interaction of central and peripheral changes associated with Parkinson's disease than to aging alone. (C) 2008 Elsevier Ltd. All rights reserved.